Thyroid cancer can be detected in early stage using ultrasonography, but there are also questions about the necessity of screening tests due to its high survival and low recurrence rate. In this study, a cost-effectiveness analysis of thyroid cancer was conducted for better patient selection with cases diagnosed by ultrasound in asymptomatic thyroid cancer.

For the analysis, Markov decision chain model were used. The post-diagnosis process for patients followed the guidelines recommended by the Korean Thyroid Association. Recurrence rates and death rates were analyzed based on 25,000 patients from our institution. The cost calculations for diagnosis and treatment followed the regulations set by the South Korean Ministry of Health and Welfare.

The average cost of diagnosis and treatment for patients diagnosed with asymptomatic thyroid cancer using ultrasound was ₩2,730,997 for 5 years and ₩3,970,652 for 10 years after diagnosis. In the case of patients diagnosed based on symptoms, the average cost was ₩3,970,652 for 5 years and ₩5,116,628 for 10 years. In sensitivity analysis, the cost range for patients diagnosed using ultrasound was ₩2,661,955 to ₩2,758,116, while for patients diagnosed based on symptoms, it ranged from ₩3,785,588 to ₩3,877,687 for 5 years.

Diagnosis using ultrasound for asymptomatic thyroid cancer offers advantages in terms of cost-effectiveness when compared to symptom-based diagnosis in Korea. Cost-effectiveness can vary due to differences in the cost of diagnosis and treatment in each country, making it essential to establish an optimized thyroid screening strategy for a specific population.